Individual
ELIZABETH BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1661 SISKIYOU BLVD, ASHLAND, OR 97520-2470
(458) 246-1498
Mailing address
2794 HIGH CEDARS LN, MEDFORD, OR 97504-3416
(626) 823-9070
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12328611-9923
UT
1223G0001X
General Practice Dentistry
Primary
D12171
OR
1223G0001X
General Practice Dentistry
DEN.00205221
CO
Other
Enumeration date
06/24/2021
Last updated
08/11/2025
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